Non-emergency Medical Transportation (NEMT) Satisfaction Survey
Why do we survey NEMT consumers?
Your opinion matters!
At Village Ambulance Service, our goal is to exceed your service expectations. That is why we regularly survey our NEMT consumers to determine what we are doing right…and what could use some improvement. The results from these surveys are one of our most important consumer-satisfaction measurement tools. Being able to hear about the quality of our NEMT services directly from you allows us to make meaningful changes in the way we do our jobs.
We greatly value your feedback. The comments we receive from you tells a story of your experiences here at VAS – a story we want and need to hear. As a matter of fact, we take the time to read every comment on the surveys.
If you would like to receive a hard copy of the NEMT consumer satisfaction survey in the mail, please contact us at 413-458-4889 and we will arrange to have one sent to you.
Thank you for helping us to provide you with the best possible NEMT experience.
____________________________________________________________________
Privacy Policy
VAS will not sell, trade, rent or release your personal information (name, email address, telephone, etc.) to others without your consent.
This site may contain links to other sites, however VAS is not responsible for the privacy practices or the content of such web sites.
We respect and work to protect your privacy. If you have any questions about this privacy statement, the practices of this site, or your dealings with VAS you may contact us.
Demographics
Consumer Name (optional):
Person completing survey (optional):
Date of service (optional):
E-mail address (optional):
Telephone number (optional):
Reason for NEMT service (optional):
Which hospital/facility were you transported to? (optional):
Survey Questions:
*Required Fields
*1. How many times have you requested NEMT services from Village Ambulance Service?
1 time
1-5 times
5-10 times
More than 10 times
*2. After requesting NEMT services, did the NEMT vehicle arrive in a timely fashion?
Yes
No
*3. How would you rate the attitude of the NEMT driver(s)?
Very courteous and professional
Courteous and professional
Uncourteous and unprofessional
Very uncourteous and unprofessional
4. What is your gender?
Male
Female
*5. How satisfied were you with the NEMT services you received?
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
*6. How comfortable was the NEMT vehicle during your transport?
Very uncomfortable
Somewhat uncomfortable
Comfortable
Very comfortable
7. Additional Comments
8. Would you like to be contacted by a VAS NEMT administrator?
a. Yes
Contact via E-mail (please complete 'E-mail' field above)
Contact via Telephone (please complete 'Telephone' field above)
b. No
